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Yakammaoto inhibited human coxsackievirus B4 (CVB4)-induced airway and renal tubular injuries by preventing viral attachment, internalization, and replication



Type of Spiritual Experience


Pinellia ternata (Chinese: 半夏, Japanese: カラスビシャク), crow-dipper, is a plant native to China, Japan, and Korea, but also grows as an invasive weed in parts of Europe (Austria, Germany) and North America (California, Ontario, northeastern United States).

Aster tataricus is a member of the Aster genus of flowering plants.  It is one of the 50 fundamental herbs of Traditional Chinese medicine, where it has the name zǐwǎn (Chinese: 紫菀). It also has an antibacterial action

Iris domestica (blackberry lily, leopard flower, leopard lily) is an ornamental plant in the Iridaceae family. In 2005, based on molecular DNA sequence evidence, Belamcanda chinensis, the sole species in the genus Belamcanda, was transferred to the genus Iris and renamed Iris domestica


A description of the experience

J Ethnopharmacol. 2014 Feb 12;151(3):1056-63. doi: 10.1016/j.jep.2013.11.049. Epub 2013 Dec 17.

Yakammaoto inhibited human coxsackievirus B4 (CVB4)-induced airway and renal tubular injuries by preventing viral attachment, internalization, and replication.

Yen MH1, Lee JJ2, Yeh CF3, Wang KC3, Chiang YW3, Chiang LC4, Chang JS5.



Yakammaoto is a prescription of traditional Chinese medicine (TCM) containing nine ingredients, including

  • Ephedra sinica,
  • Pinellia ternate,
  • Zingiber officinale,
  • Tussilago farfara,
  • Aster tataricus,
  • Ziziphus jujube,
  • Belamcanda chinensis,
  • Asarum sieboldii, and
  • Schisandra chinensis.

Yakammaoto has been used against flu-like symptoms for more than two thousand years in China and Japan. Coxsackievirus B4 (CVB4) causes not only flu-like symptoms but life-threatening diseases, such as pneumonia, acute kidney injury, and so forth with severe morbidity and mortality. There is no effective therapeutic modality against CVB4 infection. It is unknown whether yakammaoto is effective against CVB4 infection. We tested the hypothesis that yakammaoto can effectively inhibit CVB4-induced plaque formation in human airway and renal tubular cell lines by preventing viral attachment, internalization, and replication.


The fingerprint of yakammaoto was assessed by HPLC. Effects of yakammaoto on CVB4 infection were tested by plaque reduction assay, reverse transcription polymerase chain reaction (RT-PCR), and enzyme-linked immunosorbent assay (ELISA).


Yakammaoto dose-dependently inhibited CVB4-induced plaque formation in HK-2, A549, and HEp-2 cells (p<0.0001). Yakammaoto was both effective when supplemented prior to and after viral inoculation (p<0.0001) by preventing viral attachment (p<0.0001), internalization (p<0.0001), and replication (p<0.0001). Yakammaoto could decrease NGAL secretion before cytolysis to protect against viral injury.


Yakammaoto had antiviral activity against CVB4-induced cellular injuries in airway mucosa and renal tubular epithelia by preventing viral attachment, internalization, and replication. The current study provides a basic support of its potential use against CVB4-induced airway and concomitant renal injuries.

Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.


3,3',5,5'-tetramethylbenzidine; 50% cytotoxic concentration; ATCC; CC(50); CVB4; DMEM; DMSO; Dulbecco's Modified Eagle medium; ELISA; FCS; HEp-2; HK-2; IC(50); IFN; Kidney injury; PBS; Respiratory tract infection; SI; She-Gan-Ma-Huang-Tang; Sheganmahuang decoction; Sheganmahuang decoction (Chinese); TCM; TMB; Yakammaoto; Ye-Gan-Ma-Huang-Tang; Ye-Gan-Ma-Huang-Tang (Taiwan); dimethylsulfoxide; enzyme-linked immunosorbent assay; fetal calf serum; human coxsackievirus B4; human kidney 2 cell; human larynx epidermoid carcinoma cell; interferon; minimal concentration required to inhibit 50% plaque formation; pfu; phosphate-buffered saline; plaque forming unit; selectivity index; the American Type Culture Collection; traditional Chinese medicine



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